Addressing Both Depression and Pain in Late Life: The Methodology of the ADAPT Study
Identifieur interne : 000E97 ( Istex/Corpus ); précédent : 000E96; suivant : 000E98Addressing Both Depression and Pain in Late Life: The Methodology of the ADAPT Study
Auteurs : Jordan F. Karp ; Bruce L. Rollman ; Charles F. Reynolds Iii ; Jennifer Q. Morse ; Frank Lotrich ; Sati Mazumdar ; Natalia Morone ; Debra K. WeinerSource :
- Pain Medicine [ 1526-2375 ] ; 2012-03.
English descriptors
- KwdEn :
- Affective disorders, Analgesic, Analgesic medication, Analgesic properties, Angle glaucoma, Antidepressant, Antidepressant medication, Antidepressant pharmacotherapy, Antihyperalgesic effect, Arch intern, Behavioral treatment, Bromyalgia, Care approach, Caregiver, Caregiver burden, Chronic exposure, Chronic pain, Clbp, Clin, Clin geriatr, Clin psychiatry, Clin psychol, Clinical effect size, Clinical research, Clinical trial, Clinical trials, Clinician, Collaborative care, Comorbid, Cumulative illness rating scale, Daily dose, Data manager, Depressed patients, Depression, Depression pain, Depression response, Depression severity, Depression treatment, Depressive, Depressive symptoms, Disability, Dos, Effect size, Effectiveness approach, Exclusion criteria, Executive dysfunction, Factorial design, Geriatr, Geriatr psychiatry, Health edition, Higher doses, Karp, Knee osteoarthritis, Late life, Lower doses, Major depression, Major depressive disorder, Mediation effect, Medical comorbidity, Medication, Medication supplies, Mental disorders, Minor depression, Moderate reductions, Mood disorders, More improvement, Musculoskeletal pain, National institutes, Nonresponders, Numeric rating scale, Older adults, Open treatment, Optimized antidepressant therapy, Osteoarthritis, Osteoarthritis pain, Other pain conditions, Outcome measures, Pain conditions, Pain intensity, Pain management, Pain patients, Pain severity, Parallel processes, Participant, Patient health, Patient health questionnaire, Physical disability, Pilot work, Primary care, Primary care evaluation, Primary care patients, Primary care physicians, Primary pain problem, Psychiatry, Randomized, Remission rates, Response criteria, Scamp, Scamp study, Scamp trial, Secondary gain, Side effects, Simple advice, Social problem, Stable response, State examination, Study design, Subjects randomized, Suicidal ideation, Supportive management, Supportive therapy, Symptom variability, Treatment arms, Treatment durability, Treatment response, Venlafaxine.
- Teeft :
- Affective disorders, Analgesic, Analgesic medication, Analgesic properties, Angle glaucoma, Antidepressant, Antidepressant medication, Antidepressant pharmacotherapy, Antihyperalgesic effect, Arch intern, Behavioral treatment, Bromyalgia, Care approach, Caregiver, Caregiver burden, Chronic exposure, Chronic pain, Clbp, Clin, Clin geriatr, Clin psychiatry, Clin psychol, Clinical effect size, Clinical research, Clinical trial, Clinical trials, Clinician, Collaborative care, Comorbid, Cumulative illness rating scale, Daily dose, Data manager, Depressed patients, Depression, Depression pain, Depression response, Depression severity, Depression treatment, Depressive, Depressive symptoms, Disability, Dos, Effect size, Effectiveness approach, Exclusion criteria, Executive dysfunction, Factorial design, Geriatr, Geriatr psychiatry, Health edition, Higher doses, Karp, Knee osteoarthritis, Late life, Lower doses, Major depression, Major depressive disorder, Mediation effect, Medical comorbidity, Medication, Medication supplies, Mental disorders, Minor depression, Moderate reductions, Mood disorders, More improvement, Musculoskeletal pain, National institutes, Nonresponders, Numeric rating scale, Older adults, Open treatment, Optimized antidepressant therapy, Osteoarthritis, Osteoarthritis pain, Other pain conditions, Outcome measures, Pain conditions, Pain intensity, Pain management, Pain patients, Pain severity, Parallel processes, Participant, Patient health, Patient health questionnaire, Physical disability, Pilot work, Primary care, Primary care evaluation, Primary care patients, Primary care physicians, Primary pain problem, Psychiatry, Randomized, Remission rates, Response criteria, Scamp, Scamp study, Scamp trial, Secondary gain, Side effects, Simple advice, Social problem, Stable response, State examination, Study design, Subjects randomized, Suicidal ideation, Supportive management, Supportive therapy, Symptom variability, Treatment arms, Treatment durability, Treatment response, Venlafaxine.
Abstract
Objective. To describe the methodology of the first NIH‐funded clinical trial for seniors with comorbid depression and chronic low back pain.
Url:
DOI: 10.1111/j.1526-4637.2011.01322.x
Links to Exploration step
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<term>Angle glaucoma</term>
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<term>Mood disorders</term>
<term>More improvement</term>
<term>Musculoskeletal pain</term>
<term>National institutes</term>
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<term>Numeric rating scale</term>
<term>Older adults</term>
<term>Open treatment</term>
<term>Optimized antidepressant therapy</term>
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<term>Pain conditions</term>
<term>Pain intensity</term>
<term>Pain management</term>
<term>Pain patients</term>
<term>Pain severity</term>
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<term>Participant</term>
<term>Patient health</term>
<term>Patient health questionnaire</term>
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<term>Response criteria</term>
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<term>Side effects</term>
<term>Simple advice</term>
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<term>Subjects randomized</term>
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<term>Antidepressant</term>
<term>Antidepressant medication</term>
<term>Antidepressant pharmacotherapy</term>
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<term>Clin psychiatry</term>
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<term>Effect size</term>
<term>Effectiveness approach</term>
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<term>Factorial design</term>
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<term>Higher doses</term>
<term>Karp</term>
<term>Knee osteoarthritis</term>
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<term>Lower doses</term>
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<term>Major depressive disorder</term>
<term>Mediation effect</term>
<term>Medical comorbidity</term>
<term>Medication</term>
<term>Medication supplies</term>
<term>Mental disorders</term>
<term>Minor depression</term>
<term>Moderate reductions</term>
<term>Mood disorders</term>
<term>More improvement</term>
<term>Musculoskeletal pain</term>
<term>National institutes</term>
<term>Nonresponders</term>
<term>Numeric rating scale</term>
<term>Older adults</term>
<term>Open treatment</term>
<term>Optimized antidepressant therapy</term>
<term>Osteoarthritis</term>
<term>Osteoarthritis pain</term>
<term>Other pain conditions</term>
<term>Outcome measures</term>
<term>Pain conditions</term>
<term>Pain intensity</term>
<term>Pain management</term>
<term>Pain patients</term>
<term>Pain severity</term>
<term>Parallel processes</term>
<term>Participant</term>
<term>Patient health</term>
<term>Patient health questionnaire</term>
<term>Physical disability</term>
<term>Pilot work</term>
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<term>Primary care evaluation</term>
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<term>Response criteria</term>
<term>Scamp</term>
<term>Scamp study</term>
<term>Scamp trial</term>
<term>Secondary gain</term>
<term>Side effects</term>
<term>Simple advice</term>
<term>Social problem</term>
<term>Stable response</term>
<term>State examination</term>
<term>Study design</term>
<term>Subjects randomized</term>
<term>Suicidal ideation</term>
<term>Supportive management</term>
<term>Supportive therapy</term>
<term>Symptom variability</term>
<term>Treatment arms</term>
<term>Treatment durability</term>
<term>Treatment response</term>
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<front><div type="abstract">Objective. To describe the methodology of the first NIH‐funded clinical trial for seniors with comorbid depression and chronic low back pain.</div>
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<p><hi rend="bold">Objective. </hi>
To describe the methodology of the first NIH‐funded clinical trial for seniors with comorbid depression and chronic low back pain.</p>
<p><hi rend="bold">Methods. </hi>
Randomized controlled effectiveness trial using stepped care methodology. Participants are ≥60 years old. Phase 1 (6 weeks) is open treatment with venlafaxine xr 150 mg/day and supportive management (SM). Response is 2 weeks of PHQ‐9 ≤5 and at least 30% improvement in the average numeric rating scale for pain. Nonresponders progress to phase 2 (14 weeks) in which they are randomized to high‐dose venlafaxine xr (up to 300 mg/day) with problem solving therapy for depression and pain (PST‐DP) or high‐dose venlafaxine xr and continued SM. Primary outcomes are the univariate pain and depression response and both observed and self‐reported disability. Survival analytic techniques will be used, and the clinical effect size will be estimated with the number needed to treat. We hypothesize that self‐efficacy for pain management will mediate response for subjects randomized to venlafaxine xr and PST‐DP.</p>
<p><hi rend="bold">Results. </hi>
Not applicable.</p>
<p><hi rend="bold">Conclusions. </hi>
The results of this trial will inform the care of these complex patients and further understanding of comorbid pain and depression in late life.</p>
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<p><b>Objective. </b>
To describe the methodology of the first NIH‐funded clinical trial for seniors with comorbid depression and chronic low back pain.</p>
<p><b>Methods. </b>
Randomized controlled effectiveness trial using stepped care methodology. Participants are ≥60 years old. Phase 1 (6 weeks) is open treatment with venlafaxine xr 150 mg/day and supportive management (SM). Response is 2 weeks of PHQ‐9 ≤5 and at least 30% improvement in the average numeric rating scale for pain. Nonresponders progress to phase 2 (14 weeks) in which they are randomized to high‐dose venlafaxine xr (up to 300 mg/day) with problem solving therapy for depression and pain (PST‐DP) or high‐dose venlafaxine xr and continued SM. Primary outcomes are the univariate pain and depression response and both observed and self‐reported disability. Survival analytic techniques will be used, and the clinical effect size will be estimated with the number needed to treat. We hypothesize that self‐efficacy for pain management will mediate response for subjects randomized to venlafaxine xr and PST‐DP.</p>
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The results of this trial will inform the care of these complex patients and further understanding of comorbid pain and depression in late life.</p>
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<noteGroup><note xml:id="fn1"><p>Clinicaltrials.gov Trial Registration Identifier: NCT01124188.</p>
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<note xml:id="fn2"><p>Supported by grant AG033575 (Karp) and by grant KL2 RR024154 from the National Center for Research Resources (NCRR), a component of the National Institutes of Health (NIH), and NIH Roadmap for Medical Research. The content is solely the responsibility of the authors and does not necessarily represent the official view of NCRR or NIH. Medications were provided by Pfizer for this investigator initiated trial.</p>
</note>
<note xml:id="fn3"><p>Potential Conflicts of Interest: Dr. Karp served on advisory boards for Eli Lilly and Theravance greater than 1 year ago. He has received medication supplies for investigator initiated research from Pfizer, Eli Lilly, and Reckitt Benckiser. He owns stock in Corcept. Dr. Reynolds has received medication supplies for investigator initiated research from Eli Lilly, Pfizer, Forest, and Bristol Myers. The other authors do not declare any potential conflict of interest.</p>
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<mods version="3.6"><titleInfo lang="en"><title>Addressing Both Depression and Pain in Late Life: The Methodology of the ADAPT Study</title>
</titleInfo>
<titleInfo type="abbreviated" lang="en"><title>ADAPT Depression and Pain in Seniors</title>
</titleInfo>
<titleInfo type="alternative" contentType="CDATA" lang="en"><title>Addressing Both Depression and Pain in Late Life: The Methodology of the ADAPT Study</title>
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<name type="personal"><namePart type="given">Jordan F.</namePart>
<namePart type="family">Karp</namePart>
<namePart type="termsOfAddress">MD</namePart>
<affiliation>Departments of Psychiatry</affiliation>
<affiliation>Anesthesiology</affiliation>
<affiliation>E-mail: karpjf@upmc.edu</affiliation>
<role><roleTerm type="text">author</roleTerm>
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</name>
<name type="personal"><namePart type="given">Bruce L.</namePart>
<namePart type="family">Rollman</namePart>
<namePart type="termsOfAddress">MD, MPH</namePart>
<affiliation>Departments of Psychiatry</affiliation>
<affiliation>Medicine</affiliation>
<role><roleTerm type="text">author</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">Charles F.</namePart>
<namePart type="family">Reynolds III</namePart>
<namePart type="termsOfAddress">MD</namePart>
<affiliation>Departments of Psychiatry</affiliation>
<role><roleTerm type="text">author</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">Jennifer Q.</namePart>
<namePart type="family">Morse</namePart>
<namePart type="termsOfAddress">PhD</namePart>
<affiliation>Departments of Psychiatry</affiliation>
<role><roleTerm type="text">author</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">Frank</namePart>
<namePart type="family">Lotrich</namePart>
<namePart type="termsOfAddress">MD, PhD</namePart>
<affiliation>Departments of Psychiatry</affiliation>
<role><roleTerm type="text">author</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">Sati</namePart>
<namePart type="family">Mazumdar</namePart>
<namePart type="termsOfAddress">PhD</namePart>
<affiliation>Departments of Psychiatry</affiliation>
<affiliation>Biostatistics, University of Pittsburgh and University of Pittsburgh School of Medicine</affiliation>
<role><roleTerm type="text">author</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">Natalia</namePart>
<namePart type="family">Morone</namePart>
<namePart type="termsOfAddress">MD</namePart>
<affiliation>Medicine</affiliation>
<role><roleTerm type="text">author</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">Debra K.</namePart>
<namePart type="family">Weiner</namePart>
<namePart type="termsOfAddress">MD</namePart>
<affiliation>Departments of Psychiatry</affiliation>
<affiliation>Anesthesiology</affiliation>
<affiliation>Medicine</affiliation>
<affiliation>Geriatric Research Education and Clinical Center, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, USA</affiliation>
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<place><placeTerm type="text">Malden, USA</placeTerm>
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<dateIssued encoding="w3cdtf">2012-03</dateIssued>
<copyrightDate encoding="w3cdtf">2012</copyrightDate>
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<abstract>Objective. To describe the methodology of the first NIH‐funded clinical trial for seniors with comorbid depression and chronic low back pain.</abstract>
<abstract>Methods. Randomized controlled effectiveness trial using stepped care methodology. Participants are ≥60 years old. Phase 1 (6 weeks) is open treatment with venlafaxine xr 150 mg/day and supportive management (SM). Response is 2 weeks of PHQ‐9 ≤5 and at least 30% improvement in the average numeric rating scale for pain. Nonresponders progress to phase 2 (14 weeks) in which they are randomized to high‐dose venlafaxine xr (up to 300 mg/day) with problem solving therapy for depression and pain (PST‐DP) or high‐dose venlafaxine xr and continued SM. Primary outcomes are the univariate pain and depression response and both observed and self‐reported disability. Survival analytic techniques will be used, and the clinical effect size will be estimated with the number needed to treat. We hypothesize that self‐efficacy for pain management will mediate response for subjects randomized to venlafaxine xr and PST‐DP.</abstract>
<abstract>Results. Not applicable.</abstract>
<abstract>Conclusions. The results of this trial will inform the care of these complex patients and further understanding of comorbid pain and depression in late life.</abstract>
<subject lang="en"><genre>keywords</genre>
<topic>Clinical Trial</topic>
<topic>Geriatrics</topic>
<topic>Depression</topic>
<topic>Back Pain</topic>
<topic>Survival Analysis</topic>
</subject>
<relatedItem type="host"><titleInfo><title>Pain Medicine</title>
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<identifier type="ISSN">1526-2375</identifier>
<identifier type="eISSN">1526-4637</identifier>
<identifier type="DOI">10.1111/(ISSN)1526-4637</identifier>
<identifier type="PublisherID">PME</identifier>
<part><date>2012</date>
<detail type="volume"><caption>vol.</caption>
<number>13</number>
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<detail type="issue"><caption>no.</caption>
<number>3</number>
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<extent unit="pages"><start>405</start>
<end>418</end>
<total>14</total>
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<identifier type="DOI">10.1111/j.1526-4637.2011.01322.x</identifier>
<identifier type="ArticleID">PME1322</identifier>
<accessCondition type="use and reproduction" contentType="copyright">Wiley Periodicals, Inc.</accessCondition>
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